Former DHMC Doctor Loses License

Lebanon — A Dartmouth College professor who oversaw two master’s degree programs has lost his license to practice medicine in New Hampshire, part of a settlement with the state medical board over allegations of professional misconduct while working as a physician at Dartmouth-Hitchcock Medical Center .

As recently as last month, Mark Splaine, 48, was the director of educational programs at The Dartmouth Institute for Health Policy and Clinical Practice, or TDI . In that role, he led TDI’s master’s of science and master’s of public health programs.

He is now on administrative leave, college spokesman Justin Anderson said yesterday. The college and TDI declined to comment further.

Splaine, who is not licensed in Vermont, allegedly billed for treating patients without completing medical records for them while he was a part-time general internist for several years at DHMC, according to a recent settlement agreement with the state Board of Medicine.

In all, Splaine billed for more than 2,000 patient encounters that he didn’t properly document between 2005 and 2010, amounting to more than a third of all cases he handled during that time, the state alleged.

A disciplinary hearing before the medical board was scheduled for next month. Splaine, instead, chose to accept a deal to surrender his medical license. Under the agreement, Splaine did not admit any wrongdoing, nor did he acknowledge whether the allegations are factual.

Splaine stopped practicing medicine at DHMC in September 2010 and ceased to be employed at the hospital in June 2011, according to DHMC spokesman Rick Adams. Splaine resigned his position at the hospital rather than face disciplinary action, according to the settlement.

In an email, Adams said DHMC continues to review the matter and acted swiftly to ensure Splaine’s patients were not harmed.

“When Dr. Splaine stopped seeing patients, and due to Dartmouth-Hitchcock’s concerns regarding documentation, his patients were reassigned and reassessed, with particular focus on providing high-level care and attention to their special needs,” Adams said. “During this same time period, Dartmouth-Hitchcock was cooperating with all appropriate authorities since reporting Dr. Splaine’s resignation to the New Hampshire Board of Medicine, including providing information for the Board’s review and disciplinary process.”

Attempts to contact Splaine yesterday were unsuccessful. An automatic reply to an email sent yesterday said that he was “out of the office,” but did not elaborate on when he expected to return.

Last fall, Splaine and his colleagues at TDI celebrated the 10th anniversary of the master’s of public health . The one-year program explores the relationship between traditional public health and the nation’s health care system.

The TDI website no longer lists Splaine as director of educational programs, though he is still listed as an assistant professor. Karen Tombs is now the acting director, according to the website.

This was not the first time Splaine has been disciplined by the New Hampshire medical board. In March 2011, Splaine settled with the state over allegations that he withheld test results from a patient for more than a year that showed the man was at high risk for prostate cancer. The board ordered Splaine to take six hours of continuing medical education, according to the settlement agreement. However, Splaine failed to provide the board with proof that he completed the required courses.

Splaine has a lengthy history at Dartmouth. After receiving his bachelor’s degree from Harvard College in 1986, he went to what was then known as Dartmouth Medical School and graduated with honors in 1991, according to his curriculum vitae. He then did his residency at DHMC, during which time he taught internal medicine at the medical school. He was employed at DHMC from 1994 until 2011.

Splaine has been licensed to practice medicine in New Hampshire since 1994, according to state records.

The period of time during which Splaine’s alleged misconduct occurred overlapped with other unrelated billing irregularities at DHMC. Dartmouth-Hitchcock has paid out nearly $3 million in the past two years to settle two billing fraud cases with the federal government. The first of those cases involved thousands of claims between 2001 and 2007, and the second involved claims made between 2004 and 2008.

In those two cases, DHMC admitted no wrongdoing, and hospital officials have said the billing problems were the result of honest mistakes made by doctors who were trying to navigate a confusing system.

In the Splaine case, Dartmouth-Hitchcock reported his actions to the U.S. Office of the Inspector General in 2011 and agreed to pay $65,934 relating to the claims, DHMC’s Adams said.

Since then, DHMC has stepped up efforts to monitor documentation practices and aim to prevent billing mistakes from happening again, he said.

“Since the implementation of our eD-H electronic medical record, Dartmouth-Hitchcock now has ongoing monitoring of the completion of provider documentation,” Adams said. “This data is shared at the department, section and provider level, to ensure accountability at all levels.

“We understand that, with an employee and provider base of 8,500 individuals, mistakes can be made, but we work as hard as we can to eliminate those mistakes, and to improve our practices and processes based on what we learn from such situations.”